Considering How and Why Deterrence Works in Public Health

Author: Dr. Kristina Talbert-Slagle (Yale University)

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Public health experts often approach “deterrence”—or prevention of behaviors and/or decisions that adversely affect health outcomes—by considering the many factors that influence health behaviors and decision-making. These factors, often called “health determinants,” can be divided into three levels: micro- (individual), meso- (social/community), and macro- (systems). Interventions to influence health-related decision-making at each level have been developed, tested, and refined for a variety of public health deterrence efforts. Successful deterrence in public health often requires recognizing the interdependence of multiple factors within these levels and developing adaptive interventions to impact individual and group behavior. This paper describes several academic models and tools for understanding public health deterrence and then examines how those resources have been successfully utilized in an iterative, evidence-informed, adaptive approach to ultimately reduce tobacco smoking in the United States.

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